| NPI | 1144647843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101260315) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: PA MT200073) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D94712) | |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2022-12-15 |